DERANGED SERUM LIPID LEVELS IN WOMEN WITH PREECLAMPSIA.

Background; Preeclampsia (PE), as a risky pregnancy, is a systemic disease characterized by hypertension, proteinuria and edema, which are thought to be the result of diffuse endothelial activation and dysfunction. About 5% of all pregnant women have PE during the second half of gestation that can cause maternal death throughout the world and is accompanied by substantial perinatal morbidity and mortality. Objective; To determine the frequency of dyslipidemia in women with preeclampsia at a tertiary care hospital.   Material and Methods; A total of 135 women with preeclampsia (Both primigravida and multigravida) aged 20 – 40 years were included in our study.  Patients with twin pregnancy, taking lipid lowering therapy were excluded from our study. Detailed history and physical examination was conducted. Five ml venous blood sample was drawn and sent to central pathology laboratory of Nishtar Hospital, Multan for serum lipid profile estimation. Data was analyzed by using SPSS Version 20. Results; Mean gestational age of our study cases was 33.24 ± 2.77 weeks. Mean age of our study cases was 29.61 ± 3.54 years. Family history was positive in 41 (30.4%) of our study cases. Diabetes was present in 25 (18.5 %) of our study cases. Mean parity was 2.59 ± 1.72 and 77 (57.0%) had parity up to 3. Mean body mass index of our study cases was 25.85 ± 2.54 kg/m2 and obesity was present in 31 (23.0 %) of our study cases. Of these 135 study cases, 104 (77.0 %) were illiterate while 31 (23.0%) were literate. Of these 135 study cases, dyslipidemia was present in 73 (54.1%). Mean Serum Cholesterol level was 223.45 ± 47.21 mg/dl and it was deranged in 71 (52.59 %), mean serum LDL level was 147.15 ± 31.25 mg/dl and it was deranged in 72 (53.33%), mean serum triglyceride level was 154.21 ± 15.29 mg/dl and it was deranged in 70 (51.85%) of our study cases and mean HDL level was 52.42±8.53 mg/dl while it was deranged in 14 (10.37%).   Conclusion; Very high frequency of dyslipidemia was noted in our study in pre-eclamptic women. Dyslipidemia was significantly associated with gestational age, parity and diabetes.  All the preeclamptic women should be screened for serum lipid levels and be managed accordingly to avoid future fetomaternal adverse outcomes. Keywords; Preeclampsia, dyslipidemia, Frequency. DOI: 10.7176/JMPB/52-0

SENSITIVITY AND SPECIFICITY OF VISUAL INSPECTION WITH LUGOL’S IODINE S(VILI) IN CERVICAL CANCER.

Introduction: Cervical cancer is the second most common gynecologic cancer worldwide, accounting for 13% of all female cancer in developing countries. Cervical cancer is a disease that can be prevented through both primary prevention and early detection. Pap smear is a screening method which has been used for so long. Hence, one simple diagnostic test namely visual inspection with Lugol 's iodine (VILI) which is based on the ability of the trained healthcare personnel to detect yellow non iodine uptake areas in the cervical transformation zone are currently being evaluated in the experimental setting as potential alternative to cervical cytology. Objective: To determine diagnostic accuracy of visual inspection with Lugol's iodine (VILI) taking histopathology as gold standard among patients of cervical cancer. Subjects and methods: A total of 285 women with early marriage, history of post-coital bleeding, history of post- menopausal bleeding and history of per vaginal discharge were included in study. Women with obvious cervical growth and diagnosed cervical cancer were excluded. I put each patient in the  lithotomy  position and insert Cusco's speculum to visualize cervix. I cleaned the cervix with cotton soaked with normal saline. Now applied Jugol 's iodine, to the cervix normal squamous epithelium contain glycogen and stain.  Conversely premalignant and malignant squamous tissue contain no glycogen and does not stain with iodine. This was schillers test and non-staining areas were schiller positive. For further confirmation I took biopsy from schillers positive area and sent for histopathology. Results: Age range in this study was from 21 to 60 years with mean age of 39.393± 6.66 years and mean duration of disease was 6.031±2.09 months. 43.9% patients were belong to rural area and 56.1% belongs to urban area. 25.6% patients have Family History of cervical cancer. Visual inspection with Lugol's iodine (VILI) diagnosed 43(15.1%) patients and Histopathology diagnosed 15.8% patients with Cervical cancer. Visual inspection with Lugol's iodine (VILI) has shown sensitivity of 86.6%, specificity 98.3%, diagnostic accuracy by 96%, PPV 90.6%, NPV 97.5%, (p=0.000) in diagnosis of Cervical cancer.  Conclusion: My study showed VILI good sensitivity and it can therefore be a suitable potential alternative/adjunctive screening test not only in resource-poor settings but also in well-equipped centers. Keywords: Cervical cancer, Visual inspection with Lugol's iodine, Diagnostic accuracy DOI: 10.7176/JMPB/52-0

Factors leading to dyspepsia in renal transplant recipients

Introduction: Renal transplantation is the definitive treatment for end stage renal disease. Patients subjected to transplantation require lifelong immunosuppression and are prone to several gastrointestinal disorders. Dyspepsia is a common disorder in these patients. The objective of this study was to determine factors leading to dyspepsia in renal (kidney) transplant recipients. Methods: it was a cross sectional study conducted at department of hepatogastroenterology and transplant sciences, SIUT Karachi, from 1-6-15 to 1-12-15 for six months. All renal transplanted patients having dyspeptic symptoms for more than 6 weeks. EGD was performed, biopsy specimens obtained from antrum and duodenum, these were sent for histopathological examination. Frequency and percentages were obtained for categorical variables, mean ± SD was calculated for continuous variables. Chi square test was used for categorical variable and student t-test for continuous variables. Results: Ninety patients were included in the study out of which 64 (71.1%) were males, mean age was 35.82 ± 10.04 years (range: 18-65 years). Gastritis (non H.pylori associated) in 78 (78.6%), duodenitis in 35 (38.9%) and H. pylori infection in 29 (32.2%), renal transplant recipients. Most of the patients belonged to Sindhi ethnicity, 27 (30%), followed by Punjabi. Hypertension was the most common co-morbid condition in our patients found in 29 (32.2%), while most of them don't have any co morbid condition. Duodenitis was found to be associated with tacrolimus use (p = 0.037). Conclusion: Gastritis is the most common factor accountable for this symptoms, followed by duodenitis and H. Pylori. Patients taking tacrolimus as immunosuppressant are more prone to develop duodenitis

Evaluation of Records of Oral and Maxillofacial Surgery Cases Reported at Abbasi Shaheed Hospital and Karachi Medical and Dental College, Pakistan

Background: Oral and Maxillofacial Surgery department is a diverse field in dentistry. Record maintenance has been established as one of the key factors in the success and integrity of health care institutes.Objective: The objective of the study was to evaluate the records of oral and maxillofacial surgery casesreported to oral and maxillofacial surgery department, Abbasi Shaheed Hospital and oral surgery OPD ofKarachi Medical and Dental College.Methods: Cross sectional study was conducted in at ASH and KMDC from July 2019 to September 2019.The data from January 2017 to July 2019 was retrospectively noted through electronic surgical recordof ASH and records of the Oral Surgery OPD of KMDC. Inclusion criteria was patients records of bothgenders of 5–70 years age, having complaint of any oral or dental pathology or pathologies, trauma andimpactions. Data was calculated manually by calculating frequencies and percentages for the trauma,impaction and pathology cases of patients.Results: In 2017, 239 cases were treated under general anesthesia from which trauma 11. 45% (n=11),followed by 48. 11% (n=115) cases of oral pathologies, total 11.7% (n=28) cases of complicated exodontias. In2018, among 211, 51.1% (n=108) cases were trauma followed by 39.3% (n=83) cases of oral pathologies,whereas, total 9.4% (n=20) complicated exodontias cases were observed. During 2019 (January to July),168 cases 36.2% (n=62) cases were diagnosed as trauma, in oral pathology, overall 36.2% (n=62) caseswere surgically excised. Total 23.2% (n=39) complicated exodontias. In 2017, 25122 cases were reported in Surgery OPD of Karachi Medical and Dental College. Total 36.2% (n=9097) teeth were extracted from which 1.93% (n=486) cases were surgical impaction. On the other hand, 1.65% (n=416) patients were treated through minor oral surgeries. In 2018, 29008 cases were reported in Surgery OPD. Total 42.7% (n=12377) teeth were extracted from which 0.92% (n=268) cases were surgical impaction. On the other hand, 0.71% (n=208) patients were treated through minor surgeries. In 2019, January till July 13028 cases were reported in Surgery OPD. Total42.6% (n=5559) teeth were extracted from which 0.66% (n=87) cases were surgical impaction. On the other hand, 0.68% (n=89) patients were treated through minor surgeries.Conclusion: It has been concluded that evaluation of the records of oral and maxillofacial surgery casesreported to oral and maxillofacial surgery department, Abbasi Shaheed Hospital and oral surgery OPD ofKarachi Medical and Dental College were high and appropriate measures should be taken in order tomanage these problems timely and effectively

Extending Transit Facility to India: Implications for Pakistan’s Bilateral Trade with Afghanistan

The paper examines patterns of bilateral trade between Pakistan, India, Afghanistan and CARs. It also investigates whether providing India transit route to Afghanistan has opportunity costs for Pakistan’s trade potential with Afghanistan and CARs. In 2009, Pakistan’s exports to Afghanistan amount to US$ 1.3 billion which make up for 7.8 % of Pakistan’s total exports. For the same year, India’s exports to Afghanistan stand at 471 million dollars which make 0.3 % of India’s total exports. Looking at the product wise composition of Pakistan’s exports to Afghanistan, mineral fuels, oils, distillation products are on the top with share of around 29%. Salt, sulpher, earth, plaster, lime and cement and cereals have a share of around 11 %. While animal, vegetable fats and oils, cleavage products and articles of iron and steel have the share of around 7%. On the other hand, the top five exports of India to Afghanistan are man-made filaments with 42 % share, pharmaceutical products with 11 % share, electric and electronic equipment with 7% share and rubber and articles with 6% share. Clearly there is no overlap between exports of Pakistan and India to Afghanistan. Nonetheless Pakistan has already lost its market share to India in pharmaceuticals. The tariff applied to Pakistan by Afghanistan on pharmaceuticals is 2.50 % while India which enjoys Preferential Trade Agreement with Afghanistan only faces an average tariff of 0.60% on pharmaceuticals. Pharmaceuticals are Pakistan’s top performing exports to CARs with 42.5 % share of total exports to CARs. India also exports pharmaceuticals to CARs but its share in total exports to CARs is only 25.5 %. In Afghanistan, Pakistan has clearly lost its market share to India due to presence of preferential tariffs for India in Afghanistan. If Pakistan provides transit route to India for its exports to Afghanistan, cheaper pharmaceuticals of Indian origin can then be re-exported to CARs capturing Pakistan’s market share in CARs. Much like pharmaceuticals there are other Pakistani products which are likely to lose out to India in Afghanistan and CARs if India is provided transit route to Afghanistan. The Wagah-Peshawar-Torkham route which roughly extends up to 800 km is probably the shortest possible one between India and Afghanistan; which would greatly reduce the logistics cost of shipping goods from India to Afghanistan and beyond. In addition to that, the preferential treatment currently enjoyed by Indian products in Afghanistan under the PTA would further cost Pakistani goods by eroding their competitiveness in the Afghan market. In the absence of a robust mechanism to contain the informal trade, allowing Indian goods a passage through Pakistan’s territory would, in all likelihood, worsen the smuggling situation, something Pakistan can ill afford to accept. Therefore, under the circumstances, there are clear economic disadvantages to Pakistan in extending the transit facility to India without adequate safeguards and preferably a quid pro quo, be it political or economic.International Trade, Transit Trade Agreements, Pakistan, India, Afghanistan, Sectoral Analysis

Influence of high-dose gamma radiation and particle size on antioxidant properties of Maize ( Zea mays L.) flour

Influence of high-dose gamma radiation and particle size on antioxidant properties of maize (Zea mays L.) flour was studied using response surface methodology. A central composite design based on three levels of each of particle size, in terms of mesh number (40, 60 and 80 meshes), and gamma radiation dose (25, 50 and 75 kGy) was constructed. A statistically significant dose-dependent decrease (

Deep learning-based change detection in remote sensing images:a review

Images gathered from different satellites are vastly available these days due to the fast development of remote sensing (RS) technology. These images significantly enhance the data sources of change detection (CD). CD is a technique of recognizing the dissimilarities in the images acquired at distinct intervals and are used for numerous applications, such as urban area development, disaster management, land cover object identification, etc. In recent years, deep learning (DL) techniques have been used tremendously in change detection processes, where it has achieved great success because of their practical applications. Some researchers have even claimed that DL approaches outperform traditional approaches and enhance change detection accuracy. Therefore, this review focuses on deep learning techniques, such as supervised, unsupervised, and semi-supervised for different change detection datasets, such as SAR, multispectral, hyperspectral, VHR, and heterogeneous images, and their advantages and disadvantages will be highlighted. In the end, some significant challenges are discussed to understand the context of improvements in change detection datasets and deep learning models. Overall, this review will be beneficial for the future development of CD methods

Prevalence and severity of urinary incontinence among females after normal vaginal delivery

Background: Urinary Incontinence is the most common disorder associated with women after vaginal delivery due to the weakening of pelvic floor muscles. More than 50% of females experience urinary incontinence. It is defined as the involuntary leakage of urine. The condition is common not only in older women but also in young nulliparous women. Objective: The key objective of the study was to determine the prevalence and severity of Urinary Incontinence after normal vaginal delivery. Method: The study was Cross-sectional and there were 160 participants in the study. The study was conducted at the Physical Therapy department and Gynaecology Ward of Fauji Foundation and Geo hospital Lahore. The data was collected from women who had delivered between the ages of 20-40 years. The data collection was done by using Incontinence Severity Index that was used as primary outcome measure. Results: A total of 160 responses were received, based on inclusion and exclusion criteria. Among respondents, females in the age group of 20-25 had a rate of urinary incontinence with 31.3 percent. Results showed that females in the age group of 25-30 had high BMI and had a high rate of urinary incontinence with the range of 61.3 percent. As result, there was a positive correlation of urinary incontinence between age and score that ranged from 0.185. There was a positive correlation of urinary incontinence between the score and BMI that ranged between 0.174. Conclusion: This analysis revealed that there was a high prevalence rate of urinary incontinence among females after delivery that had a correlation with age